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Today, Fox News medical contributor Dr. Marc Siegel dismissed Berwick as a “basically a policy wonk” who “hasn’t really practiced since 1989.” Siegel tried to score points with sound bites. “This guy has more quotes than Yogi Berra, and let me tell you something, these quotes are an indictment on people that want clinicians to make decisions,” Siegel said on Fox this afternoon.

According to Siegel, comparative effectiveness “doesn’t work in the real world.” Well, sure, that’s the point of clinical decision support. Best practices are for common conditions, and clinical decision support is to help physicians either follow best practices in the case of common conditions or, just as importantly, diagnose and treat ailments that they don’t often see. (Read Dr. Atul Gawande’s best seller, “Complications,” for a description of the chaos that ensues when physicians see rare cases.)

Fox News anchor Megyn Kelly tried to feign fairness by saying of President Obama’s recess appointment that installed Berwick as CMS administrator last year, “lots of presidents do it.” But she later said that that Berwick “loves” the British National Health System, trying to paint Berwick as a socialist. Once again, this isn’t about socialism or capitalism or any other ism that has unfortunately been the focus of “health reform” in this country. It’s about trying to improve the quality of care. (It’s not about insurance, no matter how many politicians or pundits say so.)

Defending Berwick was Dr. Cathleen London, a family practitioner at the Weill Cornell Iris Cantor Women’s Health Center in New York City. London took issue with Berwick’s opponents relying on sound bites to make their thin arguments. (Siegel smugly laughed this off.)

When Kelly again tried to tie Berwick to the NHS, London said, “He likes that we do evidence-based medicine, that the British have NICE that actually oversees what the NHS should cover and shouldn’t.” Yes, the British National Institute for Health and Clinical Excellence (NICE) is an independent advisory board that helps the NHS make coverage decisions. You know, the same way any insurance system, public or private, has to decide what and what not to cover.

To his credit, Siegel praised Berwick’s work at the Institute for Healthcare Improvement for helping to reduce deaths in hospitals. “He’s apparently very well liked among patient safety advocates,” Kelly added.

London noted that former CMS Administrator Tom Scully, a George W. Bush appointee, is a fan of Berwick. Still, Siegel continued on his argument that comparative effectiveness is restributive in that it takes healthcare away from some people. “You’re not going to be able to pay for very expensive care,” Siegel said.

Why exactly would we want very expensive care in cases where less expensive but equally effective treatments are available? Is it because of the public perception that more expensive care automatically means better care? It sounds like Siegel is either trying to perpetuate that myth or protect the profits of pharmaceutical and device manufacturers. But then he made the salient point that “insurance is overused” and that healthcare reform, which he derides as “ObamaCare,” did little to address that problem.

All that says is that both sides of the political debate are wrong, and the Senate Democrats are cowards for not standing up for better care.

5 responses to "Slams on Berwick are getting pathetic"

It is truly pathetic how Fox News is so misinformed on Berwick, CER, and the like. Where are sensible conservatives standing up for the truth? Almost as bad as the Democrats who refuse to defend Berwick. It seems that we can no longer have rational discussion about health care issues. So sad…

Two aspects of US healthcare that blind us to taking effective actions.

(1) I think the sad but true issue is one you raise almost in disbelief: “Is it because of the public perception that more expensive care automatically means better care?”

Yes. We think if it costs more it is better. If you do more, it is better. We do not accept the risks of doing more nor the benefits of doing less.

(2) We love rescue medicine, whether it is the ability to keep victims of major trauma alive (military, industrial, vehicular) or the late-term interventions for cardiac and other chronic diseases.

It’s hard to make headlines out of check lists and adherence to protocols.

Don Berwick is a brilliant choice to head CMS. The more I learn about his history of accomplishement, the more I want to see him given the clear support of a Senate confirmation. Our loss that it’s not going to happen.

[…] didn’t make the starting lineup, but am an early choice from the bullpen for my “Slams on Berwick are getting pathetic” post. Curiously, Shafrin wades away from the controversy a bit by highlighting something said by a […]

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Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
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